Martin Sime is director of the Scottish Council for Voluntary Organisations, and writes a monthly column for The Caledonian Mercury.
When we think about our older years, most of us expect that if we need care and support, it will be there. We imagine that we will live independently in our homes for as long as possible and that the health and care system will step in to support us if we need it to. But the gap between expectation and reality is growing ever wider.
The latest figures from the
National Records of Scotland predict that between 2010 and 2035 the number of people aged over 75 will increase by 82 per cent. We are having fewer children than ever before and our already stretched budgets and services are close to breaking point.
The
International Monetary Fund says that until 2050, when the baby boomer effect subsides, the costs of an ageing population will dwarf those of the financial crisis. It seems that nothing short of radical reform will help us to avert a crisis.
It was in this context that SCVO commissioned a report,
A life worth living, to consider every angle of this challenge – from formal and informal care to health and economics, morality and the third sector’s role.
Lots must change, and change fast, if we are going to cope. But where exactly do we want to go and how will we get there? We are living longer, but how can we make sure that the extra years are worth living? That was the essence of the report.
Let’s face facts. Our ageing population and the unsustainable costs it generates for our public services means that we will have to get used to the idea of paying more and expecting less support from the government. We will have to do more to help ourselves and each other. We can’t rely on the state alone to look after us in our old age any more.
Calls are growing for a move away from our obsession with longevity rather than quality of life. Rather than doctors being trained to keep people alive for as long as possible, perhaps more attention should be given to the quality of life that our older people experience in their final years?
Around a quarter of an individual’s lifetime health expenditure is spent on the last few months or years of life. Would we want to continue spending in this way, even if we could afford it? An open discussion about these sensitive issues is long overdue.
We need a more personal health and care system that supports people to make their own choices and puts older people at the centre. We need to learn to become good neighbours and citizens again, since our ageing population is an issue which touches everyone and we will only get through this by working together.
I’m convinced that supported self-help is the only practical way of reducing demand for care and generating savings for the public purse in the process.
There are already many good schemes and projects all over Scotland – lunch clubs, community transport, befriending – but they are at the margins of our health and social care systems when they should be at the centre, reducing demand for hospitals and care services.
The integration of our health and care services must progress more quickly and the third sector should be supported more so it can help people to help themselves and play a central role in reshaping how we care for our older people.
Young and old, frail and healthy – we are all getting older and we will all feel the impacts of our ageing population. It’s time to find new ways for individuals, the public sector and the third sector to work together.
A life worth living can be
downloaded from the SCVO website.
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